Aim. The objec­tive of this study was to ­assess the sen­si­tiv­ity and spec­i­fic­ity of a newly devel­oped param­e­ter: the ankle peak sys­tol­ic veloc­ity (APSV) to pro­vide an objec­tive assess­ment of the ­degree of periph­er­al ische­mia.Meth­ods. In phase 1 of the study: data was pros­pec­tive­ly col­lect­ed for 21 ischem­ic limbs and 5 ­healthy vol­un­teers. APSV was cal­cu­lat­ed as the mean value of the dis­tal ante­ri­or and pos­te­ri­or tibi­al arter­ies peak sys­tol­ic veloc­ities (PSV). Ankle bra­chi­al index (ABI) was cal­cu­lat­ed for the ante­ri­or tibi­al and pos­te­ri­or tibi­al arter­ies. A mean ABI for both tibi­al arter­ies was also cal­cu­lat­ed. APSV was cor­re­lat­ed with the mean ABI. Cut off val­ues were cal­cu­lat­ed to dif­fer­en­tiate crit­i­cal, mod­er­ate and no ische­mia. In phase 2 of the study data was pros­pec­tive­ly col­lect­ed for 37 ischem­ic limbs and 5 ­healthy vol­un­teers, to ­assess the sen­si­tiv­ity and spec­i­fic­ity of the cut off val­ues of the APSV to iden­ti­fy limbs with crit­i­cal ische­mia, mod­er­ate ische­mia, and no ische­mia.­Results. APSV cor­re­lat­ed strong­ly with the mean ABI (r=0.8, p<0.01). The sen­si­tiv­ity and spec­i­fic­ity of APSV in iden­ti­fy­ing crit­i­cal ische­mia were 90% and 87%, for mod­er­ate ische­mia they were 75% and 88%, and for dif­fer­en­tiat­ing limbs with any ­degree of ische­mia from nor­mal limbs they were 100% and 100%, respec­tive­ly.Con­clu­sion. APSV can be used as an alter­na­tive to ABI for the assess­ment of ­degree of periph­er­al ische­mia.